High Institute of Nursing Professions and Health Technics of Rabat, Rabat, Morocco.
Laboratory of Health Sciences and Technics, High Institute of Health Sciences, Hassan 1st University, Settat, Morocco.
Health Qual Life Outcomes. 2020 Mar 10;18(1):63. doi: 10.1186/s12955-020-01313-3.
EQ-5D is generic measure of health-related quality of life. Studies using EQ-5D generate ordinal data that are interpreted as categories ordered by severity. New analytic approaches taking into account the ordinal nature of the health dimension severity and leading to a better interpretation of EQ-5D data are needed to better elucidate differences in health-related quality of life. We propose utilizing the Improved RIDIT statistical method to analyze EQ-5D outcomes.
556 Moroccan participants aged over 18 years representing four chronic diseases: back pain (n = 158), renal insufficiency (n = 56), diabetes (n = 82) or hypertension (n = 80) and healthy subjects (n = 180). All participants received the two EQ-5D versions. Two other published data sets were included. The first was extracted from a diabetic Spain study and the second was extracted from a clinical trial study. The Improved RIDIT analyses were carried out using an R statistic program we developed.
Applying the Improved RIDIT on the EQ-5D data allowed estimating for the first time the ordinal odds, the Absolute Risk Reduction (ARR) or the Absolute Risk Increase (ARI) and the Number Needed to Treat. The ARI values estimated for Moroccan patients showed that (i) hypertension increased anxiety/depression by 66% and reduced mobility by 65%; (ii) back pain increased pain/discomfort by 69%; (iii) renal insufficiency impacts mobility (ARI = 57%, odds = 9.95) and usual activities (ARI = 44%, odds = 6.41) and (iv) diabetes acts only on anxiety/depression (ARI = 50%, odds = 4.8). Also, we demonstrated that the approach works well in clinical trials.
Improved RIDIT provides more intuitive and informative interpretation of the EQ-5D data by (1) taking into account the level severity; estimating (2) the odds ordinal, (3) the ARR/ARI and the NNT; (4) analyzing the five dimensions of the EQ-5D separately, which gives clinical teams more precision in understanding the treatment/pathology impacts on the health status and completes the EQ-5D data analysis based on score utilities.
EQ-5D 是一种通用的健康相关生活质量衡量标准。使用 EQ-5D 进行的研究产生了有序数据,这些数据被解释为按严重程度排序的类别。需要新的分析方法来考虑健康维度严重程度的有序性质,从而更好地解释 EQ-5D 数据,以更好地阐明健康相关生活质量的差异。我们建议利用改进的 RIDIT 统计方法来分析 EQ-5D 结果。
556 名年龄在 18 岁以上的摩洛哥参与者,代表四种慢性疾病:背痛(n=158)、肾功能不全(n=56)、糖尿病(n=82)或高血压(n=80)和健康受试者(n=180)。所有参与者都接受了两种 EQ-5D 版本的测试。还纳入了另外两个已发表的数据集。第一个是从西班牙的一项糖尿病研究中提取的,第二个是从一项临床试验研究中提取的。使用我们开发的 R 统计程序进行了改进的 RIDIT 分析。
首次应用于 EQ-5D 数据的改进 RIDIT 允许估计有序优势比、绝对风险降低(ARR)或绝对风险增加(ARI)和需要治疗的人数。为摩洛哥患者估计的 ARI 值表明,(i)高血压使焦虑/抑郁增加 66%,活动能力减少 65%;(ii)背痛使疼痛/不适增加 69%;(iii)肾功能不全影响活动能力(ARI=57%,优势比=9.95)和日常活动(ARI=44%,优势比=6.41);(iv)糖尿病仅影响焦虑/抑郁(ARI=50%,优势比=4.8)。此外,我们还证明了该方法在临床试验中效果良好。
改进的 RIDIT 通过以下方式提供了对 EQ-5D 数据更直观和更具信息量的解释:(1)考虑严重程度级别;(2)估计有序优势比;(3)ARR/ARI 和 NNT;(4)分别分析 EQ-5D 的五个维度,这为临床团队提供了更精确的理解治疗/病理对健康状况的影响,并补充了基于得分效用的 EQ-5D 数据分析。